Provider Demographics
NPI:1518155829
Name:RYAN, KATHERINE S (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:S
Last Name:RYAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 MEDICAL CENTER BLVD.
Mailing Address - Street 2:ER
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072
Mailing Address - Country:US
Mailing Address - Phone:504-349-1533
Mailing Address - Fax:504-349-1530
Practice Address - Street 1:1101 MEDICAL CENTER BLVD.
Practice Address - Street 2:ER
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072
Practice Address - Country:US
Practice Address - Phone:504-349-1533
Practice Address - Fax:504-349-1530
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-11
Last Update Date:2016-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA202559207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine